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Bruises - Contusions

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Introduction

Everyone has experienced a bruise at one time or another.  A bruise, medically termed a contusion, results when the blood vessels beneath the skin are injured and bleed.  Cold packs can help reduce bruising following an injury.  Significant bruises should be evaluated by a doctor.
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Anatomy

Your skin covers your body and protects it from the environment.  Networks of vessels supply blood to your skin and carry waste products away to help keep the skin nourished and healthy.  A bruise develops when the blood vessels in the skin are injured, causing bleeding beneath the skin.
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Causes

A force that contacts the skin causes bruises.  For example, falls, bumping into something or punches can cause bruises.  A greater force is required for a bruise to develop in a young person than in an older person because as people age, the blood vessels become more fragile.

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Symptoms

A new bruise may be flat or swollen.  A bruise hurts and changes color over time.  New bruises are red, but after a day or two turn purple or blue.  After about six days a bruise turns green.  Older bruises are yellow-brown.  It takes about two or three weeks for the body to repair a bruise and for the skin to return to a normal color.
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Diagnosis

You should seek emergency medical treatment if you have experienced severe trauma.

You should contact a doctor if you have a blood clotting disorder or take blood thinner medications.  You should contact your doctor if a bruise gets larger or harder and does not appear to be going away.

A doctor can diagnose a bruise by looking at your skin.  You should tell your doctor if you have experienced a fall or trauma.  Your doctor may order X-rays if a bone fracture is suspected.
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Treatment

You can help decrease bruising if you apply a cold pack right after an injury.  Do not apply ice directly to the skin.  Instead, place ice cubes in a plastic bag, and wrap the plastic bag in a towel.  You may also use a cold pack that is available in most drug stores.

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Prevention

Wear appropriate protective gear when playing sports.  Older adults who have an increased risk of falls should discuss fall prevention with their doctor or physical therapist.
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Am I at Risk

People with certain medical conditions have a higher risk for bruises.  Such conditions include:
• Heart valve infections (endocarditis)
• Blood-clotting problems (platelets, hemophilia, liver cirrhosis)
• Autoimmune diseases
• Broken bones (fractures)


Certain medications can increase the risk of bruising, including:
• Prescription arthritis medications
• Over-the-counter non-steroidal anti-inflammatory medications
• Prescription “blood thinner” medication
• Prescription cortisone medications
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Complications

Some people may experience bruises by chance, without a traumatic incident.  Spontaneous bruising can be the sign of a serious bleeding tendency.  You should contact your doctor if you experience bruising without an incident.

In some cases, blood may pool under the skin or a muscle creating a hematoma.  A hematoma can cause the bruise to increase in size or raise.  A hematoma can cause increased pain. 
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

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